President Reagan appointed Dr. C. Everett Koop to be the Surgeon General of the United States. President Obama has nominated Dr. Vivek Hallegere Murthy to become the Surgeon General. The contrast between these two men speaks volumes about the politicization of this office and how this administration has cheapened it.

The irony of this entire debate is that the people who know the most about delivering care to patients were excluded from the development of the ACA. The physicians involved in crafting the administration’s vision, such as Drs. Ezekiel Emanuel and Donald Berwick, were far removed from day to day patient care.

Several weeks ago, as the country was facing a government shutdown and a debt ceiling crisis was looming, Republicans in both houses of the Congress called for a one year delay of the Obamacare individual mandate. They were branded as jihadists and domestic terrorists for taking this stance. Now, everything has changed.

If President Obama is the name attached to the Affordable Care Act and the federal government overreach into healthcare, then Kathleen Sebelius is the face. When Congress passed the ACA and the President signed it into law, she was instantly elevated to a position of unlimited power over healthcare. She owns this mess as much as he does.

When the government rationing of care commences as most critics of Obamacare expect to see, (as we already see in countries with socialized healthcare like Great Britain and Canada), expect that those with political connections will move to the top of the list.

All across the country, state governors are under tremendous pressure to accept federal funds for expansion of their state Medicaid programs. Most of this originates in Washington and the Obama administration, but much is local and comes from special interests such as hospitals.

The Affordable Care Act (ACA, Obamacare) has given Secretary Sebelius incredible and unprecedented latitude regarding virtually all aspects of American health care decision making. The ACA left the regulatory scope of the law including the powers granted to the Secretary intentionally vague, potentially allowing her office unlimited oversight into every aspect of healthcare.

Said Baucus: “small businesses have no idea what to do; what to expect. They don’t know what affordability rules are. They don’t know when penalties may apply. They just don’t know. I see a huge train wreck coming.”

Just a few months ago, the Obama administration had serious concerns regarding formation of state health insurance exchanges. This vital component of the ACA is necessary to move it forward, yet only 17 states agreed to build exchanges.

These same governors who disagreed so emphatically with Obamacare, when presented with the promise of “free money” from the federal government to grow the number of patients on Medicaid, have little problem with this.

There can be no better example illustrating the differences between a system which rewards hard work and personal responsibility versus one where all incentives are removed. Obamacare is emblematic of a system which destroys incentives to work and the reason why over 70% of physicians oppose it.